Prevalence of Comorbidities Among Rheumatoid Arthritis Patients in India: A Multicentre Observational Study

Background: Comorbidities in rheumatoid arthritis (RA) patients vary significantly, with prevalence ranging from 3% to 60%. However, limited data exist from India. This study aims to evaluate the prevalence of comorbidities in RA patients in Indian clinical settings. Methods: The multicentre, observational study was conducted across eight centres in India using data from the Indian Rheumatology Association database. Comorbidities were classified using the International Classification of Diseases, Tenth revision (ICD-10) Charlson Comorbidity Index. Data were categorised by comorbidity, age and region and analysed using descriptive statistics, Fisher’s exact test, chi-squared test, t -test, analysis of variance (ANOVA) and logistic regression. Results: The study included 4,655 RA patients who met the European League Against Rheumatism (EULAR) classification criteria, with a mean age of 52.42 ± 12.18 years. Comorbidities were present in 41.72% of the patients. Those with comorbidities were older (56.16 vs. 49.74 years) and had a longer duration of RA (122.34 vs. 107.67 months). Out of 1,942 patients with comorbidities, 90% were female and 72% were from Southern India. The major comorbidities included hypertension (21.87%), thyroid disorders (14.5%) and diabetes (11.99%). Patients over 50 years had higher prevalence of diabetes, hypertension and cardiac diseases, while younger patients had more migraines and thyroid disorders. Conclusion: RA patients in India have a significantly higher burden of comorbidities, with hypertension, thyroid disorders and diabetes being the most common. Older age and a greater proportion of patients residing in Southern India were associated with increased comorbidities, suggesting potential regional differences in risk factors, healthcare access or lifestyle. These findings highlight the need for region- and age-specific management strategies.